Cover Story

They Said No

What happened when 12 nurses refused to help their hospital perform elective abortions

Nurses in a big city hospital never know what a day’s shift will bring – straightforward cases or medical miracles, major crises or minor first aid. Whatever her station, whatever the duty of the moment, a nurse tries to ready herself for anything. But some things, you just can’t see coming.

It was Beryl Otieno Ngoje’s turn to work the desk in the Same Day Surgery Unit at the University of Medicine and Dentistry of New Jersey (UMDNJ), in Newark. She was busy with the usual administrative duties – filing charts, handing out forms to the patients, answering visitors’ questions – when another nurse hurried up beside her.

“Oh, something just happened, you won’t believe it,” the woman said, visibly excited. “I have it in my hand.” She held up a clenched fist, palm up. “I have it in my hand,” she said again.

“What do you have in your hand?” Beryl asked, bemused at the woman’s demeanor.

“Do you want to see?”

“Yes,” Beryl said – and instantly regretted it.

The other nurse opened her hand to reveal the tiny, tiny form of a baby, just aborted.

“I felt like somebody had just hit me with something in my face,” Beryl remembers. She began to cry, to the consternation of her coworker.

“I’m sorry – I didn’t know you were going to react like that,” the woman said.

It was a moment that seared Beryl’s soul and haunted her memory, and it would come back often, in the days ahead. For the other nurse was not just a co-worker, but her manager … with the power to hold not just an unborn baby, but Beryl’s career in the palm of her hand.

The dozen-or-so nurses of the UMDNJ Same Day Surgery Unit – like nurses at any other hospital – are a lively mixture of backgrounds and personalities. Beryl, a native of Kenya, is a quiet ICU specialist who’s been with the hospital for over 15 years. Fe Racpar Vinoya Esperanza is from the Philippines, and speaks with cheerful delight about her love for music and for her church. Lorna Mendoza has been a nurse for 25 years, at University for more than a dozen, and takes both her work and her Christian faith very seriously.

“We high-five each other,” Beryl says, “Most of us are there 12 hours, and that is a good portion of your day. It is important that you get along and feel relaxed and free.”

But, “you don’t get to socialize a lot,” Fe says. “You’re more busy here than in the ER.”

The nurses of Fe’s unit are responsible for monitoring, medicating, and placating patients going into and coming out of surgery. That means a lot of bedside comfort, encouragement, and interaction with both patients and their families, so conversations between coworkers tend to be quick exchanges in the hallway or on break. What the nurses share, more than close friendship, is delight in and commitment to a job they love.

“It’s a noble job,” says Fe. “Very fulfilling … a healing profession. Everything you do for the patient just makes them feel better, and satisfies my entire being, because I’ve helped someone.”

“A lot of people don’t realize … we usually see somebody at their worst,” Beryl says. “They’re not perky, happy – they’re ailing and hurting. They just want somebody to be there. I can make a difference. I can help in whatever little way. I find that very gratifying.”

All operations on this unit are elective – that is, the patient chooses to have a specific procedure done: a tonsillectomy, a hernia repair, the removal of cataracts. And, sometimes, an abortion.

Not the kind of abortion where the mother’s life is in danger, Beryl says. “They just choose to end it. These are people who go to the doctor and say, ‘Look, I don’t want this pregnancy.’ The age range is mostly teenagers – 13-, 14- and 15-year-olds – and a lot of times, they come back.”

“To some, it’s like contraception,” Fe says. “Five or six times, you see them there.”

If she ends up talking to those patients, she says, “I always tell them, ‘I’ll be praying for you, and I hope that this is the last time I’ll see you doing this kind of procedure.’ I can see in their faces how guilty they feel, the guilt in their hearts.” Many say, “Yes, definitely this is my last time.”

And yet, so often, they come back.

Fe knows, all too well, about that guilt in their eyes. Twenty years ago – still new to America, still learning the language and culture, just getting the hang of her first nursing job – she found she was pregnant. But her doctor said the number of rubella antibodies in her blood was too low, and posed far too great a risk for the baby. He urged her to get a therapeutic abortion.

Fe and her husband pressed the doctor repeatedly – was this absolutely necessary? He assured them it was, and, out of their depth in a new country, they didn’t realize they had any choice. Fe soon found herself in a clinic, surrounded by half-a-hundred teenagers, all waiting their turn to abbreviate the life in their wombs. Fe sat with her husband and sister.

“We were the only ones crying,” she says.

Right up until the moment of the procedure itself, Fe was on the phone with her doctors, trying to get their okay not to end her baby’s life. But her pediatrician and the specialist were adamant, and she went through with what they told her to do. The decision has troubled her ever since.

“I wasn’t able to sleep for a long time,” she says. “It took me years to just feel that, okay, it’s done. I asked for forgiveness. The Lord knows my heart, that I didn’t want to have that happen.”

Within a year, Fe was pregnant again. She is now the mother of three … yet her thoughts linger, sometimes, on the one she lost. The experience makes it that much harder, she says, to watch the young teenagers come through to eliminate a child just because it might complicate their lives. She knows how their hearts will be haunted in ways they can’t imagine now.

Which is why she was horrified to learn that she was being ordered to help with their abortions.

The change came in September of 2011, with the news that a peer was being promoted. Though employed in the same unit as Fe, Beryl and the rest, this particular nurse had long been assigned to a special team that carried out the abortions without any involvement or assistance from other nurses on the Same Day Surgery floor. The abortion team had always drawn its staff from nurses who had expressed no qualms about helping end a child’s life.

Promoted from that team to a supervisory position over all the nurses, the new assistant manager announced that – since she and others had to help with abortions – she saw no reason why every nurse shouldn’t help. Hospital officials agreed, and passed a new, mandatory policy to make it so. The assistant manager quickly set up a training program that would give each nurse on the unit hands-on experience in how to assist with and clean up after abortions.

“As long as you work here,” she told the 12 nurses who openly protested, “you’re going to have to do it. If you don’t, you’re going to be fired or transferred out.”

“All these years I’ve been a nurse,
I was never told to help kill children.”

Fe Esperanza, R.N.

“We were all shocked,” Fe says. “All these years I’ve been a nurse, I was never told to help kill children.”

But the managers remained adamant. Hospital administrators supported them. When the nurses brought up a long-standing, in-writing agreement exempting them from taking part in abortions apart from a medical emergency, officials told them “an emergency” would hereafter be defined as any situation in which the patient was “bleeding.” And every birth involves bleeding.

“I knew we were going to lose our jobs,” says Lorna, who, at one point, amid the flurry of discussions with the managers, was asked to provide a patient with a bedpan. Retrieving it, she found an aborted baby inside. Horrified and sobbing, she called for help, telling the manager who responded, “I don’t know what to do with this. I can’t do this.” She soon found herself in the office of the vice president of nursing, where she was accused of refusing to help patients and threatened with termination. She wasn’t the only one called in.

“Our jobs were hanging by a string,” Beryl says. “We were like, ‘All right. If they’re going to fire all 12 of us, fine. But this is against what we believe God wants us to do.’ We didn’t come into this profession to do [abortions]. We told them we weren’t comfortable with it and didn’t feel they should force us. And if that meant our jobs, well … God was going to provide.”

When even their own union declined to help them, Fe wrote a letter to hospital officials saying that she and her coworkers would not participate in abortions. She passed it around for the other nurses; 15 signed it. Bypassing her manager, she submitted the letter to the director of nursing. Response was swift. A meeting was called for the next day, with each of the signing nurses, the labor board, a union official, the managers, and “an expert on ethics” scheduled to be on hand.

The day of that announcement, Pastor Terry Smith, of Life Christian Church in West Orange, New Jersey, returned from a trip. A staff member told him that one of his parishioners – Fe – had called, shared what was happening at the hospital, and asked for advice. The pastor immediately phoned Len Deo, president of the New Jersey Family Policy Council.

“I’ll be all over this,” said Deo, who hung up and called Alliance Defending Freedom. Shortly afterward, staff attorney Matt Bowman was on the phone with a local allied attorney, Demetrios Stratis, enlisting him to help defend the nurses. The two immediately called Fe.

“I remember … I was driving and speaking to them three-way,” says Fe, who had just been convincing herself the nurses’ case was hopeless. “I didn’t know a thing about conscience law – it was very, very new to me.” The two told her she had a legitimate case, and offered to defend her. Best of all, Stratis said he could be on hand for her meeting with the managers the next day.

“Is there a catch?” Fe asked. Visions of sky-high attorneys’ fees danced in her head.

Next morning, she met Stratis at the hospital entrance. She took him upstairs to the Same Day Surgery Unit and introduced him to the nurses on duty and others waiting for the meeting. Twelve of the 15 immediately agreed to have him and Bowman represent them in the case.

“These are pre- and post-operative nurses. They’re not even supposed to be there for a surgery, whether it’s abortion or not.”

Matt Bowman

“A godsend,” Beryl says. “We had no idea which way to go. It was like something from heaven just dropped in our lap at the right time. It boosted our morale a lot.” It did considerably less for the morale of the nurse managers and others gathered for the meeting, who had not reckoned with the nurses hiring outside counsel.

“Who are you?” a manager asked Stratis.

“He’s our attorney, and he is going to speak on our behalf,” replied Fe. Everyone split into huddles – Stratis and the nurses in one room, administrators in another. After a few minutes, the nurse manager came to cancel the meeting, but not before Stratis made it clear that he would be defending “my clients’ legal right not to be forced to participate in terminating a pregnancy.”

“It was like we had been talking to a brick wall, and that brick wall just got smashed,” Fe says. “We were very happy after that. It gave us a sense of hope.”

Stratis and Bowman reminded hospital officials – face to face and in writing – that their new policy transgressed both state and federal laws that make it illegal to compel medical professionals to violate their conscience by forcing them to help with a non-emergency abortion. With their actions, the hospital was not only risking a lawsuit, but more than $60 million in federal funding. Still, administrators stubbornly contended that all abortions in the Same Day Surgery area – each scheduled weeks in advance – were “emergencies.”

“These surgeries are, by definition, elective, outpatient procedures,” Bowman says. “If they weren’t, the ER is just 30 seconds away.” Plus, he points out, “these are pre- and post-operative nurses. They’re not even supposed to be there for a surgery, whether it’s abortion or not.”

To get around that, he says, the abortion team “would give a woman a pill that induced labor, give it in the pre-op area, and leave her there. After a couple of hours, she’d start going into labor.” And now, she was outside the surgical area – in a section for which the 12 pro-life nurses were responsible.

With the hospital unwilling to budge, Alliance Defending Freedom filed suit on behalf of the 12 nurses to defend their legally protected right of conscience. Their managers, meanwhile, insisted on including the 12 in abortion training, which included interactions with abortion patients and handling dead babies. Three were forced to take part before the nurses enlisted Bowman and Stratis. Once hired, though, the two quickly obtained an injunction that prevented other nurses from having to undergo training the following day.

One of the three forced to train did not quite accomplish, perhaps, what her managers had in mind. During her shift, a patient expressed reluctance to go through with the procedure. The nurse talked with her awhile, then – at her request – quietly brought in the woman’s husband. After a bit, the woman dressed and they left … having decided not to have the abortion.

For weeks, the 12 nurses worked in a decidedly tense environment.

“It was scary,” Beryl says. “We prayed a lot. We came into work and stepped off the elevator and said, ‘God just let the day go by well, without incident’ – because we had our incidents. It was very, very uncomfortable.” The 12 drew strength, she says, from each other, from praying friends, and from their faith that, “Our God is greater than this.”

As a court date drew nearer, the hospital came up with another threat: if the 12 would not help with abortions, administrators would hire nurses who were willing to do so. Soon, officials intimated, there might not be work enough for everybody … in which cases those nurses willing to do anything might well enjoy greater job security than those only willing to do most things.

Amid all the tension, threats, and growing media coverage, the judge in the case stunned everyone by suddenly announcing, in a preliminary hearing, that a settlement had been reached.

“We had gotten everything [the 12 nurses] requested,” Stratis says. “We’d gotten the hospital to agree not to force them to perform these abortions. There would be no retaliatory measures against them, and they could feel free and sleep at night, knowing that the next day they would not have to be trained on the abortion process or help a woman kill an innocent child.”

“I was crying – really crying,” says Lorna, who heard the news from one of the other nurses. “And very thankful. The next day, I went to work, and all of us were hugging and very happy.”

“Before, I used to think that some prayers won’t be answered,” Fe says. “Sometimes, I’d feel very hopeless. But with this case, I saw how the Lord moves … providing the resources, the people who would help us out. It just strengthened my faith. I really thank God for Alliance Defending Freedom.”

“I’m not sure I know where we’d be today if it wasn’t for them, really,” Beryl says. “We were up against some really big guns, and Alliance Defending Freedom was determined to support us.”

“This case took an emotional toll on all of these nurses,” Stratis says. “To stand up, to be part of a lawsuit against their employer, is very, very hard to do. There was a lot at stake. Some were the sole breadwinners for their family. Being faced with termination of their job or standing up for their faith … that is a very, very difficult decision, especially in these economic times.”

But “I couldn’t do what they were asking me to do,” Beryl says. “I could not. You go against what you believe, what are you? What’s left? Just a shell of what you are.”